[Neoadjuvant Radiochemotherapy Followed by Curative Resection in Patients with Advanced Non-Small Cell Lung Cancer in...

Area of Science:

• Thoracic Surgery
• Medical Oncology
• Radiation Oncology

Background:

• The role of surgery after neoadjuvant radio-chemotherapy (RCT) for locally advanced non-small cell lung cancer (NSCLC) remains unclear.
• Optimal treatment strategies for stage IIIA/IIIB NSCLC are critical for improving patient outcomes.

Purpose of the Study:

• To evaluate postoperative survival after neoadjuvant RCT and surgical resection in locally advanced NSCLC.
• To identify prognostic factors influencing survival in this patient cohort.

Main Methods:

• Retrospective analysis of 46 patients with locally advanced NSCLC (IIIA/IIIB) who underwent curative resection post-RCT.
• Data collected included preoperative regression, perioperative outcomes, survival, and pathological remission.
• Median radiation dose was 50.4 Gy; R0 resection was achieved in 96% of patients.

Main Results:

• Overall 5-year survival was 47%, with a 45% progression-free survival.
• Responders to RCT (partial/complete regression in 70%) had a 64% 5-year survival rate, significantly better than non-responders (24%, p=0.038).
• Perioperative morbidity was 37% with 4% 30-day mortality.

Conclusions:

• Tri-modality therapy (RCT followed by surgery) improves prognosis for locally advanced NSCLC.
• Complete pathological remission is a key prognostic factor for long-term survival.
• Distinguishing between responders and non-responders to neoadjuvant RCT has significant therapeutic implications.